What you need to know in preparation for travel.
Traveling is one of my greatest joys! I love having the privilege of traveling with my friends, family, colleagues, and just solo. Of course, as an ER doctor, staying healthy while traveling is always front of mind, so let’s go through the things you should consider before you even arrive at your destination!
Before You Depart
We all know the importance of being prepared! This rings true for travel health as well.
Disease Prevention
Being sure you’re up to date on both routine vaccinations and travel-specific vaccinations is extremely important before visiting a different country. When it comes to routine vaccinations, it’s not uncommon for there to be outbreaks of diseases like measles in various countries around the world. In addition, there are several vaccine-preventable illnesses that you may not be exposed to at home, but are common in the country you’re traveling to. Some examples of this are Hepatitis A & B, Typhoid, Yellow Fever and Malaria (requires pills, rather than a vaccine).
It’s important to have a consultation with a travel health expert to go over your itinerary and get all of the necessary travel vaccines before travel. Although most vaccines require at least 2 weeks to work, there are several vaccines (like Hepatitis B) that require multiple doses over several months, so it’s important to get that consultation as early as possible to plan accordingly. Your travel health expert will also talk to you about different medications that may be required for travel (for example, Malaria prophylaxis).
Medications & First Aid
In addition to ensuring that you bring enough of your prescribed medications with you, it’s also important to have a well-stocked travel first aid kit. It can be challenging to find even over the counter medications when you’re away from home, due to different regulations on what requires a prescription vs. what can be found over the counter. Here are the medications and first aid items I never leave home without (click on the image for a link to a detailed outline on my Instagram page):
Travel Health Insurance
I cannot overemphasize the imporatnce of having comprehensive travel health insurance. Many higher end credit cards offer this, but it’s something that you need to check before you leave. It typically quite affordable (on our last trip to Vietnam, most quotes were about $200 for a family of 4 for 3 weeks of travel).
As an ER doctor, I have seen countless cases of patients being re-patriated back home with hundreds of thousands of dollars of medical bills following them. I have also seen situations where people who become critically ill or injured while traveling have been denied life-saving medical care because they have been unable to afford the upfront costs of diagnosis and treatment.
This isn’t a joke. Even if you’re completely healthy, accidents happen, and if you live in a place (like Canada) where you don’t have to think twice about the cost of medical care, it’s easy to forget to address this before traveling.
Research the Country
As a part of being prepared, I always check travel advisories and other health advisories related to the country I’m traveling to. This includes knowing ahead of time if the drinking water is safe and whether there are any government or CDC travel advisories.
I also map out where there are international hospitals and embassies, so that I have some peace of mind in case of emergencies.
During Your Journey
The emphasis on staying healthy during travel also includes the actual travel portion.
Long haul travel (either by plane, vehicle, or train) can be a risk factor for a blood clot in your leg, called a deep vein thrombosis (DVT). A journey of more than 4 hours can slightly increase the risk of a DVT, so it’s important to do what you can to prevent them from occurring, especially if you have any of the following risk factors:
- recent major surgery
- a history of previous blood clots
- cancer
- pregnancy
- obesity
- you’re taking an estrogen containing medication
- you have a blood clotting disorder
For those with risk factors, it’s important to talk to your doctor before you travel to discuss whether taking a preventative medication would be indicated for you.
Even if you don’t have risk factors, there is still a risk of getting a DVT during travel, so here are some things you can do to decrease this risk:
- wear compression stockings (graduated compression and 30-40 mmHg of pressure)
- get up to walk every 1-2 hours
- flex and extend your ankles and knees frequently (the muscle movement helps keep the blood moving in your leg veins)
- stay well hydrated
- avoid alcohol
The risk of travel-related DVT is highest in the first 2 weeks, so it’s important to see a doctor if you think you may have one. Signs of DVT include pain, swelling, or redness to your calf or thigh.
Blood clots can dislodge from the leg and travel to your lungs, causing a pulmonary embolism (PE), which can be a medical emergency. Symptoms of PE include chest pain, shortness of breath, racing heart, lightheadedness/dizziness, or passing out. If you think you have a PE, go to the ER right away (one of the reasons that I look up clinics and hospitals at my destination before I travel).
I’ll be back next week with Part 2 of this series, talking about travel health after you arrive at your destination.
